Consumer Reports takes look at state medical groups

The next time you hear someone recommend a doctor - or you are about to recommend one - ask yourself how much anyone really knows about the quality of care that any doctor provides.

The doctor may be accomplished and may have impeccable credentials. He or she may be knowledgeable, patient and kind. The doctor may even have diagnosed and treated a serious illness that a spouse or friend or you had.

Yet you still probably don't know much about the quality of care that is provided.

Consumer Reports, best known for its ratings of cars, washing machines and other consumer products, is taking the first steps toward changing that.

The magazine will publish a special edition next month for Wisconsin that contains a 20-page insert on the performance of 19 medical groups on a sampling of quality measures.

The medical groups provide care to about half of the state's residents. The quality measures are only for primary care and provide no more than a snapshot. And information is not available on specific doctors.

But it's a start.

"We are not to the Model T yet," said John Santa, a physician and director of the Consumer Reports Health Ratings Center. "We have a long way to go. That's why we are pleased to be doing this. We have a lot to learn."

The information is from the Wisconsin Collaborative on Healthcare Quality, a consortium of health systems, medical groups and others, that has been at the vanguard of developing and tracking measures on the quality of care provided by doctors.

The Collaborative, founded in 2002, now tracks and discloses how medical groups perform on 32 quality measures, such as controlling blood sugar in patients with diabetes.

The information, voluntarily reported by its members, has long been available on the Collaborative's website - www.wchq.org- but has been used by relatively few patients.

Consumer Reports has more than 100,000 print and online subscribers in Wisconsin. And one of the goals of the special insert is to increase awareness of the Collaborative's information.

The insert, which will be available on the Collaborative's website, will focus on cancer screening tests, care for people 60 and older, and care for people with heart disease.

Gauging the quality of care provided by a medical group is more difficult than gauging the quality of a blender - and gauging the quality of a blender isn't easy.

"You are talking about an enormous amount of complexity," Santa said.

Consumer Reports brings to the project its skill at summarizing information in a clear and accessible format - and its familiar rating system of four black or red circles.

"You have to convey information in 30 seconds," Santa said.

Consumer Reports published similar ratings for Massachusetts and Minnesota this year. The project is funded by the Robert Wood Johnson Foundation as part of its initiative Aligning Forces for Quality.

The Massachusetts insert, published in May, provided ratings on patient experience. The Minnesota insert, published in August, provided ratings on how 552 physician practices manage patients with diabetes and heart disease.

"It helps when the state says, 'OK, everyone has to get this done,' " Santa said.

The Wisconsin Collaborative on Healthcare Quality has been gathering information on quality measures longer than its counterparts in other states. And it has steadily added new measures over the years.

When the Collaborative started out, it had to develop its own measures.

"As the work has matured, as the science evolved, there now are well-endorsed measures," said Chris Queram, president and chief executive officer of the Collaborative.

Still, scant information is publicly available on the quality of care provided by physicians, and there are few public quality measures for specialists.

That, though, is slowly changing.

The federal agency that oversees Medicare will begin releasing some information on the quality of care provided by physicians next year under the Affordable Care Act. It does the same now for hospitals and other health care providers.

The information initially will be limited but is likely to grow over time. That happened with hospitals, which now report their performance on a long list of quality measures available on Medicare's Hospital Compare website - www.medicare.gov/hospitalcompare.

Health insurers also increasingly are rating physicians on how they interact with patients, the quality of care they provide and how wisely they use health care dollars.

For now, the Wisconsin Collaborative on Healthcare Quality has information only on medical groups. But in the spring it plans to provide information on specific clinics. It doesn't have any immediate plans to provide information on specific physicians.

"There still are many technical and methodological issues," Queram said.

The group also will need to move cautiously so as not to hurt the reputation or career of a physician by providing inaccurate information.

"That's the challenge we all face moving to the next level," Queram said.

The next big step is to gauge the efficiency of physicians. The Wisconsin Health Information Organization, an outgrowth of the Collaborative, has been working on that for several years and could begin releasing information next year.

The medical groups in the Collaborative provide care for only half of the state's residents, although several medical groups plan to join.

"These doctor groups in Wisconsin should be commended for starting this effort in 2003," Santa said. "But there are a lot of doctors in Wisconsin who are not participating."